Melanoma is a skin cancer that starts in melanocytes (cells that make melanin), which give skin its pigment, or color. Sometimes these cells change, often because of damage caused by sun exposure. Over time, this damage may result in cancer.
Approximately 70,000 new cases of invasive melanoma are diagnosed in the United States each year. While melanoma accounts for only 3% of all types of the skin cancer, it has the highest death rate of all types and is more likely to spread (metastasize) in the body. It is also one of the most frequently occurring cancers in young adults ages 20 to 30, and is the main cause of cancer death in women 25 to 30 years old.
Melanoma usually appears as an:
- Irregular brown, black and/or red spot or
- Existing mole that begins to change color, size or shape
Melanoma appears most commonly on the trunk area in fair-skinned men and on the lower legs in fair-skinned women. In dark-skinned people, melanoma appears most frequently on the palms, the soles of the feet and the skin under nails. If caught early, melanoma is often curable.
Melanoma Types
Melanoma typically falls into one of the following three types:
- Cutaneous melanoma
- Mucosal melanoma
- Ocular melanoma
Cutaneous Melanoma
There are four major types of cutaneous melanoma:
Superficial spreading melanoma:
- Most common melanoma type
- About 70% of cases
- Usually starts in a pre-existing mole
Nodular melanoma:
- Second most common melanoma type
- 15% to 30% of cases
- More aggressive and usually develops quicker than superficial spreading melanomas
Lentigo maligna melanoma:
- Appears as large, flat lesions
- Most commonly found on the faces of light-skinned women over 50
- 4% to 10% of cases
- Lower risk of spreading than other melanoma types
Acral lentiginous melanoma:
- Occurs on the palms, soles of the feet or beneath the nail beds
- 2% to 8% of melanomas in fair-skinned patients
- Up to 60% of melanomas in darker-skinned patients
- Large, with an average diameter of 3 centimeters
Mucosal Melanoma
- About 1% of melanoma cases
- Occurs in mucosal tissue, which lines body cavities and hollow organs
- Most common sites are head and neck region (including the nasal cavity, mouth and esophagus), rectum, urinary tract and vagina
- Can be very difficult to detect
- Even when diagnosed and treated, prognosis is often poor
Ocular Melanoma
Because the eyes contain melanocytes, they can be susceptible to melanoma. Read more about the two types of ocular melanoma:
Some cases of melanoma can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
Some people have an elevated risk of developing melanoma. Review the melanoma screening guidelines to see if you need to be tested.
Behavioral and lifestyle changes can help prevent melanoma. Visit our prevention and screening section to learn how to manage your risk.
Melanoma Risk Factors
Anything that increases your chance of getting melanoma is a risk factor.
Sun damage, especially a history of peeling sunburns, is the main risk factor for melanoma. Artificial sunlight from tanning beds causes the same risk for melanoma as natural sunlight.
Other risk factors for melanoma include:
- Fair complexion: People with blond or red hair, light skin, blue eyes and a tendency to sunburn are at increased risk.
- Previous melanoma
- Moles (nevi): Having a lot of benign (non-cancer) moles
- Family history of melanoma
- Atypical mole and melanoma syndrome (AMS): Previously known as dysplastic nevus syndrome, AMS is characterized by large numbers of atypical moles. If you have AMS, you and your family members should be screened regularly
Not everyone with risk factors gets melanoma. However, if you have risk factors, it¡¯s a good idea to discuss them with your health care provider.
Learn more about melanoma:
Jeffrey Gershenwald, M.D., has been treating melanoma patients at MD?Anderson for over 20 years.
5 things to know about raised moles
When people talk about moles, they are usually referring to a variety of skin growths, including true moles ¡ª which are also called nevi ¡ª freckles and other growths. However, in dermatology, a mole is a very specific type of skin growth that looks a certain way under a microscope.
Ahead, I¡¯ll share more facts you might not know about moles, including how to tell if they are healthy.
Raised or flat doesn¡¯t mean healthy or unhealthy
We can¡¯t rely solely on whether a mole is raised or flat to determine if it is healthy. Some moles and skin lesions naturally grow vertically rather than horizontally. Moles that grow up and down are going to feel more raised than moles that grow laterally.
Instead of whether a mole is raised or not, start with the ABCDE rule to help determine if your mole may be healthy or may be exhibiting signs of melanoma, a type of very high-risk skin cancer.
A is for asymmetry, or whether one half of the mole looks different from the other half.
B is for border. You can tell if your mole has an unusual border if it would be challenging to outline.
C is for color. Note if your mole is multiple colors.
D is for diameter. Is your mole larger than the size of a pencil eraser, or about 6 millimeters?
E is for evolving. Has your mole rapidly grown or begun to hurt, itch or bleed? If something is bleeding or painful, those are my signs that it should prompt attention.
You can also use the Ugly Duckling rule to determine if a mole may be abnormal. Ugly Duckling moles look different than your other spots. This could look like developing a black mole when all of the other moles on your body are brown.
If your mole meets any of the ABCDE criteria or follows the Ugly Duckling rule, make an appointment with a dermatologist for a skin cancer screening exam.
Having a high number of moles may increase your skin cancer risk
Having more moles ¡ª especially 50 or more ¡ª can increase your risk for melanoma.
If you have more than 50 moles, you are considered to have a higher risk for skin cancer and could benefit from an annual skin check with a dermatologist.
It is rarer to develop moles after age 40
Usually, after around age 40, people stop developing new moles. You can certainly develop other skin lesions after this age, though! Don¡¯t be afraid to see a dermatologist about any type of new or rapidly changing spot on your skin, or a spot that bleeds, hurts or itches.
It¡¯s possible to remove raised moles, but not always recommended
While it is possible to remove raised moles, many dermatologists prefer not to remove healthy-looking moles unless they bother or worry the patient. That¡¯s because removing a mole can leave a scar. Moles can also grow back after they are removed, which can look atypical.
I also warn patients against getting moles removed by providers who aren¡¯t dermatologists. While it isn¡¯t common, it is possible to get a skin lesion partially removed that turns out to be cancerous. This can complicate and delay a skin cancer diagnosis.
If you have a mole that bothers or concerns you, talk to your dermatologist about the best way to proceed.
When in doubt, see a dermatologist
Check your skin every month. It can be hard to notice skin changes on a daily or weekly basis, but monthly check-ins allow you to note if a mole or other spot on your skin is dramatically changing.
If you wonder if a skin spot requires a trip to the dermatologist, I always recommend making an appointment. It can be hard to figure out what skin spots are normal on your own, not to mention challenging to check your own scalp or back.
At a skin screening, a dermatologist will look at your skin, sometimes with the help of a magnifying tool called a dermatascope. They may ask you questions about the history of the spot, how long it has been there and the changes that prompted your visit.
If your dermatologist sees any concerning spots, they may perform a biopsy. This involves removing a mole and looking at it underneath a microscope to diagnose if it is cancerous.
Another benefit of making an appointment with a dermatologist for a full body skin assessment? Your dermatologist can keep an eye on any skin changes that happen over time. In this case, preventive care is as simple as taking a look at your skin.
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Why choose MD Anderson for your melanoma treatment?
Our team of internationally recognized experts provides customized treatment for melanoma to ensure you receive the most advanced care with the least impact on your body.
Multidisciplinary Melanoma Treatment
Each person and each melanoma are different, and at MD Anderson's Ben Love/El Paso Corporation Melanoma and Skin Center, we use our unique multidisciplinary approach to tailor treatment for melanoma skin cancer specifically to your unique situation.
More than 10,000 melanoma patients ¨C¨C among the most of any program in the world ¨C¨C are evaluated here each year. Caring for this large and diverse patient population has helped us develop an outstanding team of melanoma specialists with wide-ranging expertise and experience in treating all types of melanoma.
Comprehensive, Specialized Melanoma Treatment
Your personal team of experts in melanoma skin cancer may include melanoma surgical oncologists, melanoma medical oncologists, pathologists, dermatologists and dermatologic surgeons, head and neck surgeons, neurosurgeons, plastic surgeons and other surgeons, radiation oncologists, diagnostic radiologists, and other specialists if needed. They work together closely, collaborating and communicating at every step of your treatment.
Several innovative treatments for melanoma skin cancer are offered at MD Anderson, and many of them were discovered here. Your personalized treatment may include:
- Lymphatic mapping and sentinel node biopsy
- Minimally invasive limb perfusion
- Targeted therapies that capitalize on our improved understanding of the molecular alterations within melanoma tumor cells
- Adjuvant radiation therapy to help reduce the risk of melanoma coming back after surgery
- Treatments for rare forms of melanoma, such as those that begin in the eye (uveal melanoma) or mucosa (for example, vaginal, rectal or sinonasal)
Pioneering Research
And we're constantly researching ways to help the body fight
- Immunotherapy, including the latest agents such as ipilimumab, PD-1 and PDL-1 inhibitors, interleukin-2 and adoptive T-cell therapy
- Targeted therapies such as BRAF, MEK, multikinase and KIT inhibitors
- Combination
regimens - Vaccines
Since 2004, the National Cancer Institute has awarded MD Anderson a multimillion-dollar Specialized Programs of Research Excellence (SPORE) grant. This means we are able to offer a broad array of clinical trials for melanoma skin cancer.
New targeted therapies are improving and bringing hope to our patients.
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